手术教学是医学生临床实习教学中的重要组成部分,妇科学作为手术学科在实习教学中存在一定困难和问题。结合医学本科生知识结构和实习轮转特点,构建妇科学临床实习教学中手术视频预放映模式。在此基础上,于2023年6月至2024年6月,对在武汉大学人民医院妇科实习的2019级临床医学专业五年制、“5+3”一体化、八年制共82名学生采用该方法进行教学实践。实习结束时采用问卷调查方法评价教学效果,并通过学生集体访谈获取改进建议。问卷调查结果显示,在答卷的76名学生中,有70名(92.1%)学生认为增强了对解剖结构的掌握,67名(88.2%)学生认为提升了对妇科手术过程的认知,58名(76.3%)学生认为提升了对微创手术方式的认知,52名(68.4%)学生认为提升了妇科学实习兴趣,44名(57.9%)学生认为增加了从事妇科的兴趣;教学方法评价方面有多数学生(均在80.0%以上)认为该教学方法设计合理、切合实际、内容清晰易懂,51名学生(67.1%)认为整体教学效果良好。手术视频预放映模式有助于提升学生妇科手术学习兴趣和实习积极性,教学效果良好,学生对该种教学模式满意度较高。
Training of surgical techniques is a crucial component of the gynecology internship,but as a surgical discipline, gynecology faces certain difficulties and problems in internship teaching. Based on the knowledge structure of medical undergraduates and the clinical rotation characteristics, we developed a Preoperative Video Preview Teaching Method for the Gynecology internship.Based on this foundation, from June 2023 to June 2024, this educational approach was implemented with 82 students from the Class of 2019 (enrolled in the five-year clinical medicine program, the ″5+3″ integrated clinical medicine program, and the eight-year clinical medicine program) during their gynecology internship at the Department of Gynecology, Renmin Hospital of Wuhan University. Upon completion of rotation, teaching effectiveness was evaluated via a self-developed questionnaire, and group interviews were conducted to gather feedback for improvements. Results from the 76 respondents showed that: 70 students (92.1%) reported an enhanced understanding of anatomical structures, 67 students (88.2%) indicated an improved comprehension of the gynecological surgical process, and 58 students (76.3%) believed their knowledge of minimally invasive procedures increased. In addition, 52 students (68.4%) felt their interest in the gynecology clerkship was motivated, and 44 students (57.9%) expressed an increased interest in pursuing a career in gynecology. Regarding the teaching methodology itself, a large majority of students (>80% for all items) agreed that the approach was well-designed, practical, and that the content was clear and easy to understand. Furthermore, 51 students (67.1%) rated the overall teaching effectiveness as excellent. In conclusion, the preoperative video preview model effectively enhances students' interest in learning gynecological operations and their overall internship engagement, receiving high satisfaction ratings from participants.
[1] Dominic C. Marshall BSc, Justin D. Salciccioli MA, Sarah-Jane Walton MRCS,et al. Medical student experience in surgery influences their career choices: a systematic review of the literature[J]. J Surg Educ 2015,72(3):438-445. DOI: 10.1016/j.jsurg.2014.10.018.
[2] Lauren E Schmidt, Clairice A Cooper, Weidun Alan Guo.Factors influencing US medical students' decision to pursue surgery[J]. J Surg Res, 2016, 203(1):64-74. DOI: 10.1016/j.jss.201603.054.
[3] Carter, McInnis,Hamza, et al. The surgical skills and technology elective program and medical student career choice[J].J Surg Res, 2022, 273(1): 127-131. DOI:10.1016/j.jss.2021.12.020.
[4] Debra Nestel, Kirsten Dalrymple, John T.Paige, et al. 外科教育发展:理论、证据与实践[M]. 肖海鹏,匡铭,译. 北京: 人民卫生出版社, 2023:143-153.
[5] Miller S, Shipper E, Hasty B, et al. Introductory surgical skills course: technical training and preparation for the surgical environment[J]. MedEdPORTAL: The Journal of Teaching and Learning Resources,2018,14:10775. DOI: 10.15766/mep_2374-8265.10775.
[6] 吁丽平.腹腔镜手术视频在普通外科临床教学中的应用价值研究[J].当代医学,2022,28(16):187-190. DOI: 10.3969/j.issn.1009-4393.2022.16.062.
[7] 杨文娟,李翠玲,方姗.案例联合手术视频提高妇产科学习兴趣的研究[J].中国现代医生,2024,62(16):106-108. DOI: 10.3969/j.issn.1673-9701.2024.16.025.
[8] 张鹏,陶凯雄.微创手术视频教学体系在胃肠外科中的应用[J].医学教育研究与实践,2021,29(2):314-318. DOI: 10.13555/j.cnki.c.m.e.2021.02.033.
[9] 王小东,牛旭东,张磊,等.实时腔镜手术视频联合CBL教学模式在住院医师规范化培训教学中的应用[J].中国病案,2024,25(4):91-94. DOI: 10.3969/j.issn.1672-2566.2024.04.030.
[10] 邓宇,黄静君,伍筱梅,等. 艾宾浩斯遗忘曲线理论在医学影像诊断学教学中的应用[J]. 中华医学教育杂志,2013,33(4):555-557. DOI:10.3760/cma.j.issn.1673-677x.2013.04.027
[11] 刘思远.从艾宾浩斯记忆曲线谈反刍式实践教学[J].文学教育(上),2020(9):165-167. DOI:10.16692/j.cnki.wxjys.2020.09.074.
[12] 陈春花,刘平,陶昶煜,等. 参与式教学方法在局部解剖学理论课教学中的应用[J]. 中华医学教育杂志,2023,43(10):747-750. DOI:10.3760/cma.j.cn115259-20221012-01289
[13] LaPorta J Ⅲ, McClure T Ⅲ, Tieman ME. Results of a surgical simulation course designed to improve surgery clerkship performance[J]. J Surg Educ,2018,75(3):656-663. DOI: 10.1016/j.jsurg.2017.09.026.
[14] 王洪宾,张海东,李凤娟,等.模拟手术—混合式教学法在卓越班局部解剖学实验教学中的应用[J].中国高等医学教育,2022(5):98-99. DOI: 10.3969/j.issn.1002-1701.2022.05.047.
[15] 陈思萍,何小俊,李薇薇.基于艾宾浩斯记忆曲线的负反馈模拟实战演练方案在警察院校学生心肺复苏培训中的应用[J].中国急救医学,2021,41(6):494-497. DOI: 10.3969/j.issn.1002-1949.2021.06.008.
[16] 瞿田星. 艾宾浩斯遗忘曲线应用于手术室护理人员操作技能培训的学习曲线分析[J].循证护理,2024,10(7):1257-1261. DOI: 10.12102/j.issn.2095-8668.2024.07.022.
[17] 王斌,马青变,郑康,等. 社区医护人员心肺复苏能力的影响因素及对策研究[J]. 中华医学教育探索杂志, 2024,23(2):200-205. DOI:10.3760/cma.j.cn116021-20221222-01597
[18] Selten JW, Nazari T, Andriessen EH, et al. Standardized videos in addition to the surgical curriculum in medical education for surgical clerkships: a cohort study[J]. BMC Med Educ, 2022,22(1):384-393. DOI: 10.1186/s12909-022-03314-w.
